If money—and recovery time—were no object, here's what dermatologists would recommend for every decade of your adult life.
What if we had an all-access pass to the
country's best derms, and dreamier still, what if money were no object?
What pu-pu platter of procedures would we—nay, should we—indulge in over
the decades?
Since leaving New York City nearly
a decade ago, I've become firmly anchored to the Ocean State by two
decidedly non-city kids and my own intrinsic New England sensibilities.
But I still write about beauty and most days I still feel the familiar
pull—of old friends still living the dream, of the vast only-in-New-York
opportunities, and as I inch closer to 40, of the army of esteemed
anti-aging wizards I once had at my disposal. These dermatologists are
the collective Scarecrow to my Dorothy: I think I'll miss them most of all. (Sorry, friends.)
Here, I asked the pros to pull back the curtain on the ultimate age-defying treatments, decade by decade.
What To Get In Your 20s…
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Mini Fraxel, 3 times yearly:
"Twenty-somethings eat this up," says New York City dermatologist Paul Jarrod Frank of Fraxel's Clear + Brilliant laser,
which zaps dullness, gaping pores, and dark spots from both the sun and
long-departed pimples. "They don't want a heavy Fraxel—they think it's
for old people—but this lighter version improves the texture and tone of
their skin, and if done regularly, can minimize the need for more
aggressive treatments down the road." A few rounds come fall will abate
signs of a summer spent plastered to the Bridgehampton sands—but "if the
sky is truly the limit, come in on a monthly basis, while also using
sunscreen and retinol daily, and your skin will look nothing short of
fabulous," says Robert Anolik, a dermatologist in New York City.
Forma Radiofrequency (RF) Treatments, quarterly:
Think of Forma
as Thermage's kinder, gentler cousin. Both RF-fueled devices "stimulate
fibroblasts to make more collagen, keeping skin thick, and slowing down
the aging process," says Karyn Grossman,
a dermatologist with offices in Manhattan and Beverly Hills. But
Forma's energy is weaker, which translates to less pain, but also more
derm visits. And make no mistake: This isn't an instant-gratification
fix. "You won't see much of a change after one or two sessions," she
says. It's more like an insurance policy guaranteeing skin still looks
tight when you snap that inevitable #ThisIs30 selfie.
What To Get In Your 30s…
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BTL Vanquish ME, once a week for four weeks
The
non-invasive body shaping treatment uses heat to melt fat in problem
areas like love handles, thighs, and abs—essentially "stubborn fat areas
that no amount of exercise seems to ever make disappear," says Dendy Engelman, a dermatologist in New York City. What makes BTL Vanquish compelling
to women in their 30s, she explains, is that once the fat cells are
destroyed and eliminated from the body, they’re gone for good. But
Engelman also emphasizes the importance of being realistic. "I always
stress to my patients that this shouldn’t be thought of as an 'easy fix'
to not work out or eat whatever you’d like. The weight and fat can
always be gained back without a healthy lifestyle."
Neuromodulators, up to four times a year:
Just as expression lines are starting to dig in, Dr. Frank breaks out what he calls "the famous vitamin B: Botox" (though, for first-timers, he sometimes prefers the "softer look" of Dysport,
a Botox competitor.) The most common starting point for neuromodulator
injections is right between the brows, as they have "a wondrous effect"
on the angry 11 lines known to settle in there, he says, easing them
almost instantly. For those without budget constraints, Dr. Anolik books
shots every three months, explaining that toxins generally last about
four, and by reinjecting before they wear off, you capitalize on the
drug's preventative as well as corrective benefits. In short: By never
regaining full muscle movement, you can put wrinkles on
hold—permanently.
Intense Pulsed Light (IPL), two to four treatments a year:
IPL devices
painlessly deliver multiple wavelengths of light that seek and destroy
both brown sunspots and the leaky capillaries that underlie ruddiness.
"They essentially clear the canvas, and enhance cell turnover to make
skin look even-toned, radiant, and dewy—accomplishing everything we try
to achieve with makeup," says Dr. Engelman.
What To Get In Your 40s…
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Hyaluronic acid (HA) fillers, two to four times a year:
For
the first time ever, you may find yourself mourning a certain loss of
plumpness. "We start to see a marked drop-off in the volume of the face
during this decade," says Dr. Anolik. It's most obvious in the cheeks,
as they lose their soft light-catching curve, and such deflation
directly contributes to smile lines and jowls. A syringe or two of Voluma—a
thick sugar-based gel that lifts as it swells—can typically rectify
both issues in minutes. Other key filling zones for 40-somethings
include the temples, chin, and lips. While HA fillers have different
life spans—based on their viscosity and where they're placed, among
other things—Dr. Anolik encourages touch-ups every three to nine months,
noting that avid exercisers, who "metabolize filler more rapidly," tend
to keep the tightest injection schedules.
Fractional resurfacing (Ã la Fraxel Dual), three sessions a year:
That
laser once deemed only for oldies? It's now a perfect fit. Its
heightened intensity allows it to attack all forms of visible sun
damage—fine lines, large pores, rough texture, and dullness—while
simultaneously mending crippled collagen below the skin's surface.
Expect five days of redness and flaking after each session. "You won't
be in any pain during this time, and you can definitely go out, but
people will know you had something done," explains Dr. Anolik.
What To Get In Your 50s and Beyond…
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Ultherapy or Thermage, once a year:
By
50, it's high time you graduated from Forma to one of these more
powerful tightening methods. "While I can't give a true face or neck
lift with my [ultrasound-based] Ultherapy
device, I can diminish the rate at which laxity develops over time by
targeting the collagen layer with deep-penetrating heat," says Dr.
Anolik. To boost heavy upper lids and open the eyes, he treats across
the forehead and around the outer eye area. Zapping the cheeks—from the
mid-face out toward the ears—lessens smile lines and jowls. And to firm
up the neck, he starts below the chin and moves out laterally, to the
left then right, covering the entire area. For most, he achieves a one
to two millimeter lift, for an overall tauter look. But, as you've
probably heard, tightening is a no-pain, no-gain scenario. Dr. Anolik
preps patients with numbing cream, high-dose ibuprofen, and for those
"especially anxious or sensitive," a narcotic-strength pain reliever or
even Valium, he says. To his credit, he's "never had anyone jump off the
table."
Jawline and neck injections, two to four times per year:
In addition to the standard upper-face freezing, derms often start injecting neuromodulators
into the lower face in the fifties to ease the downward pull of
muscles, which contributes to sagging and folds around the mouth. Many
also count on injectables to contour slack jaw lines—be it thick,
volumizing fillers right along the jaw bone to create definition and
lift, or a bit of Botox in the chin "to give a more angular look and
help eliminate jowls," says New York City dermatologist Howard Sobel.
For those feeling bad about their necks, Botox can help reign in the
ropy platysmal bands that jut out with age. And to erase fine lines
spanning the neck, there's the thin HA filler, Belotero, which derms say spreads smoothly and invisibly under even the thinnest, most translucent skin.
Fractional ablative CO2 laser resurfacing (Ã la Fraxel Re:pair), once every five years:
"Not even a facelift can achieve what an aggressive fractional CO2
resurfacing can for wrinkles around the mouth and eyes, for crepey
texture, and for that sort of crosshatching some get on their cheeks,"
says Dr. Frank. "It can seriously take off 15 years," he says, noting
that it's ideal for those in their sixties. The catch? Ten days of
hide-inside healing post-treatment. "There's swelling and
scabbing—you're not presentable at all—but again, it's not a painful
recovery," adds Dr. Anolik. Redness may linger for about a month, but
can usually be veiled with makeup.
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